NCG020182_Supplemental Info Review (Dormant Recert)_20231213

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 12/13/2023 12:40:04 PM(Supplemental Submittal)
Accept by bethany.georgoulias 12/13/2023 3:59:53 PM(Supplemental Info Submittal)
• The task was assigned to Kaitlin Peck 12/13/2023 12:40:05 PM
• Kaitlin Peck reassigned the task to bethany.georgoulias 12/13/2023 12:49:39 PM
41 NCG

pEQNC Stormwater - Supplemental Information Upload
Submittal from 12/13/2023
Permit Information:
Please provide specific permit details below.
...................................................................................................................................................................................................................................................................................................................................................................................................
What Type of Permit? Choose one:
* 0 NPDES Industrial or MS4 Permit
0 State Stormwater(Post-Construction)Permit
Other
Permit Number* NCG020182
Begins with"SW","NCG",or"NCS'
What DEQ Office is Reviewer:Please correct if misidentified,close this review form,and reassign task to the appropriate contact.
the Primary Contact? Central Office
*
Washington Regional Office(Attn: Carl Dunn)
Wilmington Regional Office(Attn:Christine Hall)
.................................................................................................................................................................................................................................................................................................................................................................................................
Facility Name* Heidelberg Materials-Elm City Quarry
For NPDES permits
Owner/Operator* Heidelberg Materials Southeast Agg LLC
County: Wilson
Submitter Name:* Mary Ann Hoerle
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 9193576695
Additional E-mail for (Optional)
Submittal
Confirmation:
NPDES Permit Information Uploads
Choose file type and upload attachment(Reviewer may remove unnecessary submittals)
......................................................................................................................................................................................................................................
File Type* Dormant Status Recertification
File Upload Click the upload button,or drag and drop files to attach
NCG02-Dormant-Status-Certifi cation-Form-Elm City-
64.17KB
signed.pdf
Only PDF files are accepted.
........................................................................................................................................................
Is this project funded QQ No
with ARPA grant Q Yes
funds?*

Uploads contain NO
Confidential YES
Information* NOTE:The following information cannot be claimed as confidential:the name and address of any permit applicant
or permittee,permit applications,permits,effluent data,information required by NPDES application forms provided
by the Director inclusive of all forms and attachments[Ref.40 CFR 122.7(b)and(c)].
Notes about the attachments:
* By checking the box and signing box below, I certify that:
o I have given true,accurate,and complete information on this form;
o I agree that submission of this Supplemental Information form is a"transaction"subject to Chapter 66,Article 40 of the
NC General Statutes(the"Uniform Electronic Transactions Act)
o I agree to conduct this transaction by electronic means pursuant to Chapter 66,Article 40 of the NC General Statutes
(the"Uniform Electronic Transactions Act');
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature;AND
o I intend to electronically sign and submit the Supplemental Information Upload form.
Full Name:* Mary Ann Hoerle
Signature:
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Date Submitted: 12/13/2023

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
NCG020182
Who needs a Copy?* Reviewer selections will only be required for offices checked here.
Central Office Staff
Regional Office Stormwater Contact
State Stormwater RO Staff
No Copy Needed
Central Office Reviewer:*
Notifies CO Staff with Email
Brittany Cook
Any Comments or Dormant Status Re-Certification (monitoring suspension already in BIMS)
Added Info for CO
Staff Reviewer?
Review Date* 12/13/2023